Abstract
Patients presenting for surgery may have isolated or combined prolonged activated partial thromboplastin time (aPTT) and/or prothrombin time (PT). In patients not receiving anticoagulants or with no identifiable cause for abnormal clot formation, a mixing study is performed. The index of circulating anticoagulant (ICA) has been used to predict the presence of an inhibitor, usually a lupus anticoagulant. We retrospectively reviewed the results of mixing studies performed at Northwestern Memorial Hospital, between January 1, 2010 and February 29, 2012. We determined the number of samples that normalized or remained prolonged, the clotting factors associated with prolonged test results, and the presence of coagulation inhibitors. We calculated the ICA in the samples with prolonged aPTT and PT to determine its ability to predict a lupus anticoagulant. The primary comparison of interest was the diagnostic utility of the ICA at cutoff values of 11% for predicting the presence of lupus anticoagulant. There were 269 mixing studies performed: 131 samples with prolonged aPTT; 95 with prolonged PT; and 43 with both prolonged aPTT and prolonged PT. Of the samples with a prolonged aPTT, 55 of 131 (42%) normalized, 36 of 131 (27%) partially ...Continue Reading
References
Dec 1, 1989·Mayo Clinic Proceedings·M A Gertz, R A Kyle
Sep 1, 1983·Radiology·J A Hanley, B J McNeil
Mar 16, 2004·British Journal of Haematology·Pratima ChowdaryPeter W Collins
May 13, 2004·Blood·Pier Mannuccio MannucciFlora Peyvandi
Nov 24, 2005·Blood·Bin ZhangDavid Ginsburg
Dec 27, 2005·Best Practice & Research. Clinical Haematology·Wendy N Erber, David J Perry
Jul 4, 2007·Expert Review of Cardiovascular Therapy·Thomas Renné, David Gailani
Jul 4, 2007·Mayo Clinic Proceedings·Arif H KamalRajiv K Pruthi
Oct 2, 2007·Transfusion Medicine·W H Dzik
Jun 25, 2008·Haemophilia : the Official Journal of the World Federation of Hemophilia·F PeyvandiM Spreafico
Apr 18, 2009·Anesthesia and Analgesia·Kenichi A TanakaJerrold H Levy
Jan 26, 2010·Anesthesiology·Honorio T BenzonAntoun Nader
Mar 5, 2013·Seminars in Thrombosis and Hemostasis·Geoffrey Kershaw, Daniel Orellana
May 2, 2014·Anesthesia and Analgesia·Zeev N KainMaxime Cannesson
May 2, 2014·Anesthesia and Analgesia·Thomas R VetterJean-Francois Pittet
Sep 28, 2014·Critical Care : the Official Journal of the Critical Care Forum·Luis Teodoro Da LuzNeill Kj Adhikari
Apr 14, 2015·Anesthesia and Analgesia·Richard C PrielippNeal H Cohen
Jan 29, 2016·British Journal of Haematology·Gregory A Hans, Martin W Besser
Apr 14, 2016·Seminars in Thrombosis and Hemostasis·Elisa DaneseGiuseppe Lippi
Nov 29, 2016·JAMA : the Journal of the American Medical Association·Sung-Hee ChoiYu-Min Shen
Jan 8, 2017·The American Journal of Emergency Medicine·Jawad T AliCarlos Vr Brown
Dec 21, 2017·Regional Anesthesia and Pain Medicine·Samer N Narouze, Dmitri Souza
Mar 22, 2018·Regional Anesthesia and Pain Medicine·Terese T HorlockerHonorio T Benzon